How To Use CPT Code 00561

cpt 00561 describes the anesthesia services provided for procedures involving the heart, pericardial sac, and great vessels of the chest in patients younger than one year of age. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of cpt 00561.

1. What is cpt 00561?

cpt 00561 is used to describe the anesthesia services provided for procedures involving the heart, pericardial sac, and great vessels of the chest in patients who are younger than one year of age. These procedures often require the use of a pump oxygenator, which takes on the work of the heart and lungs during the surgery. The anesthesia provider is responsible for inducing and monitoring the patient during the procedure, as well as overseeing their transfer to post-anesthesia care.

2. Official Description

The official description of cpt 00561 is: ‘Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator, younger than 1 year of age.’

3. Procedure

The anesthesia provider performs a pre-operative evaluation of the patient and prepares them for anesthesia induction in the operating room or procedure room. The provider then induces the patient and monitors them during the procedure, which involves the heart, pericardial sac, and great vessels of the chest. The patient, who is younger than one year old, requires a pump oxygenator to pump and add oxygen to the blood. The anesthesia provider documents the types and amounts of medications administered, all forms of monitoring used, patient responses, and the start and stop times of anesthesia care. After the procedure, the provider oversees the patient’s transfer to post-anesthesia care.

4. Qualifying circumstances

cpt 00561 is used for patients who are younger than one year of age and require anesthesia services for procedures involving the heart, pericardial sac, and great vessels of the chest. The use of a pump oxygenator is also a qualifying circumstance for this code.

5. When to use cpt code 00561

cpt 00561 should be used when providing anesthesia services for procedures involving the heart, pericardial sac, and great vessels of the chest in patients who are younger than one year of age and require the use of a pump oxygenator. It is important to note that cpt 00561 should not be reported in conjunction with codes 99100, 99116, and 99135.

6. Documentation requirements

To support a claim for cpt 00561, the anesthesia provider must document the following information:

• Patient’s age
• Procedure performed on the heart, pericardial sac, and great vessels of the chest
• Use of a pump oxygenator
• Start and stop times of anesthesia care
• Types and amounts of medications administered
• Forms of monitoring used
• Patient responses

7. Billing guidelines

When billing for cpt 00561, ensure that the anesthesia services are provided by a qualified anesthesia provider and that the patient is younger than one year of age. It is important to follow the guidelines provided by the payer regarding the calculation of anesthesia time and the use of modifiers. Additionally, do not report cpt 00561 in conjunction with codes 99100, 99116, and 99135.

8. Historical information

cpt 00561 was added to the Current Procedural Terminology system on January 1, 2005. There have been two code changes since its addition, with the most recent change occurring on January 1, 2009. cpt 00561 was also added to the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. An anesthesia provider administering anesthesia to a 6-month-old patient undergoing heart surgery with the use of a pump oxygenator.
2. An anesthesia provider providing anesthesia services for a 10-month-old patient undergoing a procedure on the pericardial sac.
3. An anesthesia provider monitoring a 9-month-old patient during a procedure on the great vessels of the chest.
4. An anesthesia provider administering anesthesia to an 8-month-old patient undergoing a procedure on the heart without the use of a pump oxygenator.
5. An anesthesia provider providing anesthesia services for a 7-month-old patient undergoing a procedure on the great vessels of the chest with the use of a pump oxygenator.
6. An anesthesia provider monitoring a 11-month-old patient during a procedure on the pericardial sac without the use of a pump oxygenator.
7. An anesthesia provider administering anesthesia to a 5-month-old patient undergoing heart surgery with the use of a pump oxygenator.
8. An anesthesia provider providing anesthesia services for a 3-month-old patient undergoing a procedure on the great vessels of the chest.
9. An anesthesia provider monitoring a 2-month-old patient during a procedure on the pericardial sac.
10. An anesthesia provider administering anesthesia to a 1-month-old patient undergoing a procedure on the heart without the use of a pump oxygenator.